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HEALTH CARE NEWS

US Congress extends CHIP, funds opioid crisis response following temporary shutdown

Publish date: February 9, 2018

By 

Gregory Twachtman 

Oncology Practice

 

 

 

 

 

 

 

 

 

Congress, despite a second shutdown in less than a month, was able to pass a number of financial extenders to fund key health care programs.

The bipartisan spending bill (H.R. 1892), passed in the early morning hours on Feb. 9 by a 71-28 vote in the Senate (16 Republicans and 12 Democrats voted against it, and Sen. John McCain [R-Ariz.] was not present) and a 240-186 vote in the House (67 Republicans and 119 Democrats voted against and 5 representatives did not vote). President Trump signed the bill later that morning.

 

The spending bill and continuing resolution to fund the government through March 23 includes $6 billion to fund treatment for opioid addiction and other mental health issues, $2 billion in additional funding for the National Institutes of Health, and 4 additional years of funding for the Children’s Health Insurance Program. The additional CHIP funding extends the program for a total of 10 years.

The funding bill also made a technical correction to the Merit-based Incentive Payment System (MIPS) track of the Medicare Quality Payment Program. It removes Part B drug reimbursement from the MIPS payment adjustment, so any positive or negative change to physician payments based on the MIPS score will only be applied to physician fee schedule payments.

The bill also repeals the Independent Payment Advisory Board, a panel created by the Affordable Care Act that would have the power to slash Medicare spending under certain budget circumstances. That board was never convened.

The funding legislation also accelerates closure of the Medicare Part D “donut hole,” the coverage gap in which beneficiaries must pay 100% of medication costs prior to entering catastrophic coverage.

Just over $7 billion was provided for community health centers and Medicare’s therapy caps were repealed.

While the funding bill was written in the Senate with bipartisan input and received bipartisan support, Sen. Rand Paul (R-Ky.) held up votes over objections to the more than $1 trillion it will add to the nation’s debt, as well as for the fact that there was no opportunity to introduce and vote on amendments, leading to an hours-long government shutdown.

There also were concerns about two issues that could have derailed the vote in the House. Democrats wanted to add language to address immigrants brought to this nation illegally as children, while some Republicans did not want to increase the federal debt. However, there were enough votes to pass the funding legislation.

gtwachtman@frontlinemedcom.com

Too Few Women with Diabetes Receive Recommended Preconception Counseling

Drotumdi O

Too Few Women with Diabetes Receive Recommended Preconception Counseling

Article ID: 691230

Released: 15-Mar-2018 5:05 PM EDT

Source Newsroom: Endocrine Society

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CITATIONS

ENDO 2018, Mar-2018

CHANNELS

Diabetes, Local - DC, Local - DC Metro, Medical Meetings

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Newswise — CHICAGO—Not enough women of childbearing age who have diabetes are receiving the preconception counseling recommended by the American Diabetes Association (ADA), a new study suggests. The findings will be presented in a poster on Saturday at ENDO 2018, the 100th annual meeting of the Endocrine Society in Chicago, Ill.

Women with type 1 or type 2 diabetes and their babies benefit from strict blood sugar control before and during pregnancy, and the ADA recommends that all women who have diabetes and are of childbearing age receive preconception counseling beginning at puberty.

"In our study, rates of preconception counseling among women of childbearing age with diabetes were very low,” said lead study author Angela L. Magdaleno, D.O., a medical resident Lehigh Valley Health Network in Allentown, Pa. “Primary care providers believed they were providing preconception counseling with patients more frequently than they actually were."

"Previous studies have shown that preconception counseling decreases birth defects and other complications in babies of mothers with type 1 and type 2 diabetes. However, in our study, primary care physicians in Obstetrics and Gynecology, Internal Medicine, and Family Medicine did not regularly discuss glucose control or provide comprehensive counseling with their patients prior to conception," she said.

Magdaleno and her colleagues reviewed the electronic medical records of one regional health care system and identified 577 charts of women 18-35 years old with type 1 or type 2 diabetes mellitus with or without complications who had had an office visit with Obstetrics and Gynecology, Internal Medicine, or Family Medicine over a two-year period.

The researchers reviewed the office notes to determine whether the patients had received preconception counseling at the office visit. They also sent anonymous surveys to 524 providers in the system inquiring about the preconception counseling services they provided to women with diabetes.

Based on the 97 (18.5 percent) responses the authors received, providers believed they were providing preconception counseling more often than they actually were.

Overall, among all primary care providers, 39 percent believed that they were regularly (more than 80 percent of the time) providing preconception counseling to their patients with diabetes. In reality, only 18.9 percent of these patients had actually received preconception counseling during an office visit in the past three years. Obstetrics and Gynecology providers discussed preconception counseling more often (36.1 percent) than Internal Medicine (9.8 percent) or Family Medicine (7.1 percent).

"Our survey has revealed the following perceived barriers to preconception counseling: providers' lack of time, the perception that the women should request preconception counseling, and that pregnancies are unplanned," Magdaleno said.

"Organizations providing healthcare to women of childbearing age with diabetes should develop processes to implement higher rates of preconception counseling," she advised. "Based on our physician survey, primary care provider perceptions to barriers of counseling need to be addressed to improve rates of preconception discussions with women of childbearing age with diabetes."

# # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

 

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